Buspirone Explained: Usage, Dosage, And Side Effects

According to the Anxiety & Depression Association of America, anxiety disorders are the most common form of mental illness in the United States, affecting almost 20% of American adults each year. There are several different categories of anxiety disorders, including generalized anxiety disorder (GAD), panic disorder, social anxiety, phobias, obsessive-compulsive disorder, and post-traumatic stress disorder (PTSD). Buspirone is primarily used to treat GAD, which is characterized by excessive worry about a variety of events and activities (via the NIH and the National Institutes of Mental Health). 

People with GAD find it hard to control their worrying, which can pose a challenge in their personal and professional lives. Symptoms of GAD can include a keyed-up or restless feeling; impaired concentration; fatigue; irritability; aches and pains that may be felt in different places throughout the body; and trouble sleeping. It's important to note that GAD is different from the stress that many people feel as a part of normal daily life; people with GAD experience a persistent feeling of fear and dread that may not be related to a specific life situation. 

The FDA approved buspirone for the treatment of GAD in 1986 due to a wealth scientific research proving its efficacy (via Drugbank Online). Although benzodiazepines were the most widely used the go-to prescription drugs for GAD in the 80s, buspirone's popularity increased because studies showed it was equally effective and had fewer side effects (via UW Medicine and the Journal of Clinical Psychopharmacology). The main difference is that it takes buspirone longer to take effect. Anxiety disorders and depressive disorders often coexist, and buspirone has also been shown to be an effective treatment for both. In a 1992 meta-analysis in Neuropsychobiology, buspirone was shown to be significantly more effective at treating individuals with co-existing GAD and depression compared to a placebo. 

As for its off-label uses, more research still needs to be done. According to a 2015 review in the Journal of Psychosocial Nursing and Mental Health Services, most research on buspirone for substance abuse disorders had disappointing results, although one study showed positive results when it was used for heroin detoxification. A 2020 study showed that buspirone was effective for easing anxiety in patients with Parkinson's disease, however there were roadblocks posed by side effects and tolerability that led researchers to conclude that a large-scale efficacy trial was not warranted (Parkinsonism & Related Disorders). 

Buspirone may interact with medications you take for other health conditions. According to the Mayo Clinic, it's not recommended to take buspirone with the following medications due to the potential of severe interactions: isocarboxazid, linezolid, phenelzine, procarbazine, selegiline transdermal, tranylcypromine. Several of these — isocarboxazid, phenelzine, selegiline, and tranylcypromine — are monoamine oxidase inhibitors (MAOIs) that can increase the risk of a dangerous condition called serotonin syndrome when taken together with buspirone (via the Cleveland Clinic and Mental Health Clinician). Linezolid is an antibiotic that you may take if you have pneumonia or other bacterial conditions, according to MedlinePlus. Procarbazine is a drug used in chemotherapy, specifically to treat Hodgkin's lymphoma. 

Buspirone may have central nervous system (CNS) depressant effects (via Integrative Psychiatry). Therefore, the side effects of other CNS depressant medications such as antihistamines or other allergy and cold medicines, sleeping medications, prescription pain relief medications, sedatives, tranquilizers, narcotics, barbiturates, seizure medications, muscle relaxants, and anesthetics can be compounded when combined with buspirone. These effects include fatigue, lack of coordination, poor concentration, low blood pressure, and slow breathing (via the NIH).

Several other drugs, as well as plant-based supplements like ginkgo or St. John's wort, can also cause particular side effects if taken alongside buspirone (via Mayo Clinic). Though your doctor may decide you can safely use both buspirone and another drug or supplement, be sure to inform your physician about anything you take regularly so they can make an informed decision about which drugs to prescribe, and at what dosage.

You should not drink alcohol while taking buspirone (via the Mayo Clinic). You should also not stop taking buspirone without consulting your doctor first, as going cold turkey on the medication could cause withdrawal. The effects of withdrawal can include mood and cognitive issues (anxiety, confusion), stomach upset, sleep disturbances, sweating, cramping, and excessive fatigue among other things. Your doctor may recommend tapering off your dosage over a period of time so as to avoid these effects. 

If you believe you may have taken too much buspirone, you should contact emergency services. Overdose symptoms can include feeling dizzy or lightheaded, exhaustion, losing consciousness, an upset tummy, and dilated pupils. 

The liver and kidneys are crucial to how buspirone is broken down in the body and subsequently passed out through waste (via Drugs.com). Therefore, its use in people with severe liver or kidney problems is contraindicated due to the potential of a buildup of medication in the body.

If buspirone doesn't work or you can't tolerate the symptoms, there several other medications your doctor may prescribe to treat your condition. Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitor (SNRIs) are often used to treat anxiety (via the Mayo Clinic). Some examples of these medications include escitalopram (Lexapro), duloxetine (Cymbalta), venlafaxine (Effexor XR), and paroxetine (Paxil, Pexeva). There may be other antidepressants your doctor recommends based on your symptoms. These medications may be more or less effective and have more or fewer side effects, but it depends on the individual. 

Benzodiazepines are also used to treat anxiety. However, according to the Mayo Clinic, they are typically only used for short-term treatment of acute anxiety symptoms. Buspirone has advantages over benzodiazepines because it is less likely to cause sedation or memory problems, and is far less likely to provoke an addiction (per Buspirone).